Concomitant Opening-Wedge Distal Femoral Osteotomy and Anterior Closing-Wedge Proximal Tibial Osteotomy With Tunnel Bone Grafting for the First Stage of a Revision Anterior Cruciate Ligament Reconstruction

IF 1.2 Q3 ORTHOPEDICS

Arthroscopy Techniques Pub Date : 2024-09-01 DOI:10.1016/j.eats.2024.103054

Luke V. Tollefson B.S., Evan P. Shoemaker B.A., Erik L. Slette M.D., Robert F. LaPrade M.D., Ph.D.

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引用次数: 0

Abstract

Multiple risk factors for anterior cruciate ligament (ACL) reconstruction graft failure have been reported, including improper tunnel placement, unrepaired meniscus or ligamentous injuries, and coronal/sagittal malalignment. Various biomechanical studies have reported on the increased forces experienced by the ACL graft when there is valgus malalignment or increased posterior tibial slope. This technique describes an opening-wedge distal femoral osteotomy to correct valgus alignment and a closing-wedge proximal tibial osteotomy to correct increased posterior tibial slope in the setting of an ACL reconstruction graft failure. This technique is the first stage of a 2-stage surgery in which the second stage is the revision ACL reconstruction. By performing both osteotomies first, the patient can begin weight bearing earlier after the revision ACL reconstruction.

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同时进行股骨远端开刃截骨术和胫骨近端前方闭刃截骨术并进行隧道骨移植，用于前十字韧带翻修重建术的第一阶段

据报道，前交叉韧带（ACL）重建移植物失败有多种风险因素，包括隧道放置不当、未修复的半月板或韧带损伤以及冠状位/矢状位错位。各种生物力学研究报告显示，当出现外翻错位或胫骨后斜度增加时，前交叉韧带移植物所承受的力量会增加。本技术描述了在前交叉韧带重建移植物失败的情况下，通过开刃式股骨远端截骨术纠正外翻对位，并通过闭刃式胫骨近端截骨术纠正胫骨后斜度增加。该技术是两阶段手术的第一阶段，第二阶段是前交叉韧带重建术。先进行这两项截骨手术，患者就可以在前交叉韧带重建术后更早地开始负重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroscopy Techniques ORTHOPEDICS-

CiteScore

2.10

自引率

33.30%

发文量

291

审稿时长

29 weeks